Prescription Drug Monitoring Program

In 2009, the Florida legislature adopted a new law to address the state’s growing problem with prescription drug abuse and diversion. Chapter 893.055 established new guidelines for operating pain management clinics and approved development and utilization of a Prescription Drug Monitoring Program (“PDMP”) database to collect controlled substance prescription records from dispensers.

Prior to passage of the law, the Federal Centers for Disease Control labeled Florida the epicenter of prescription drug diversion because it had weak regulatory oversight of pain management practices, limited regulation of physician dispensing habits and, most importantly, no prescription drug monitoring program. Florida became known as the “Pill Mill” capital of the country.

According to DEA statistics, the state had over 900 unregulated pain management clinics in 2010. The data also showed that these clinics employed 90 of the top 100 oxycodone dispensing physicians in the country. Of the top 50 oxycodone dispensing clinics in the U.S., 49 were located in Florida and were selling more than 1 million oxycodone pills a month. Before new regulations were enacted by the Florida legislature, it was projected from state medical examiners reports that about 10 persons each day died of prescription drug overdose, primarily due to oxycodone abuse.

Florida’s prescription drug monitoring program, E-FORCSE (the Electronic-Florida Online Reporting of Controlled Substances Evaluation), began operation in 2011. The database is managed by the Department of Health, and its yearly $500,000 operating budget is raised through a non-profit, tax exempt, Direct Support Organization foundation whose board of directors is appointed by the State Surgeon General.

Because of the new PDMP law, dispensers of controlled substances must report all transactions within seven days. The law also permits all licensed heath care practitioners including physicians, dentists, osteopaths, podiatrists, pharmacists, physician assistants, ARNPs and optometrists to register and use the database in treatment planning prior to prescribing a controlled substance. Law enforcement agencies may also access the system for information to assist in investigation of active cases.

Since E-FORCSE became fully operational the oxycodone death rates have been reduced by 41%. Practitioners who use the database have the ability to check patients prescription history which can help prevent over-prescribing and identify those persons who may be doctor shopping.

As of July 1, 2014 over 112 million dispensing records have been collected by the PDMP. Also, more than 25,000 practitioners have registered for the program of which 12.4% of all licensed MDs or 8,259 are utilizing E-FORCSE. Of this total, 5,773 MDs queried the program with over 2.8M queries. The registration records show that 32% of all users are MDs.